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Home My WebLink About2004-P07204 - addn/rermodel/repair � _ PERMIT C,.TY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 Po�2o4 Crystal Bay, Minnesota 55323 P2C�711t Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 2illi2oo4 SITE ADDRESS: 1200 Bracketts Pt Rd Wayzata,MN 55391 PID: ii-ii�-23-32-000i DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Buildin Census Code 434 Permit Class: g Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: riumbing Eiec;u-icai�sia�ej NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 321.25 Valuation: $ 20,000.00 Plan Review Fee: $ 208.78 State Surcharge Fee: $ 10.50 TOTAL FEE: $ 540.53 APPLICANT: David Pinske Design&Build OWNER: John Noble 4216 Crocker Ave. 1200 Bracketts Pt Rd Edina,MN 55416 Wayzata,MN 55391 THE LJNDERSIGNID HIItF.BY REQUESl'S PERMISSION TO MAKE THE REAI,IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND SI'ATE OF MINNESOTA BUILDIN DE REQUIRFMF.NTS. � �. APPLICANTPERMITEESIG RE ISSUEDBYSIGNATURE Copies: 1-File(Sie�iitures Reauiredl, 1-Applicant, 1-Monthlv Reoorts, 1-Assessin�, 1-Finance Page 1 � �� Total Fee: $ SS�D, S3 `I q'o`� Date Received: ��3'O `� Entered By: Permit #: F�0720� CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) � ----------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) 0�1ER OR CONTRACTOR , JOB SITE ADDRESS: � �C�' � � , C�ZIP: �J� �� 1 NAME OF OWNER: V�.�� 0�-� PHONE: (home) (�vork) MAILING ADDRESS: �C�.rvv�sL� CITY: ZIP: , � r �,, � �j CONTRACTOR: 1 �'V�� . C�" ��" P NE: ��-��l �I �� . CONTACT PERSON: � �`v�-a M IL AGER: , �j�- � �� MAILING ADDRESS: d �' G /�t; CITY: ZIP:r5.S�f I� ,j�lo,S— STATE LICENSE: # \ C�� ARCHI�� GINEER: �Sa-ti'� (�'r�'� PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Addition , Accessory Structure ----------- Move Remodel :�lteration Land Alteration PROPOSED WORK (descrrbe in detai�: ��,,,,��v^�.�� yY2� =�w�,C (,��`l� � � STORIES: SQ. FEET OF EACH FLOOR: N0. OF BEDROOMS: GARAGE STALLS: ATT. DET. � ESTIMATED CONSTRUCTION VALUATION (excluding land): $_�, ZZ�C�� I hereby apply for a building permit and I acl:nowled�e that the information abo�-e is complete and accurate; that the work will be :n conformance ��ith the ordinances and codes of the City and with the State Building Code; that I understand this is not a permit and work is not to start without a permit; and that the work will be in accordance with the ro��ed plan. � � APPLICANT'S SIGNATURE: � ti�'�. DATE: �� C� NOTE.� Parade of Homes events require sepa�ate permit approval by Police Department and City Counci/60 days prior to the event. Non permitted events will not be aUowed. 1 l Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd. 2. Information required to be given individual. An individual asked to supply private or confidential data concernir.g himself shall be informed of: (a) the purpose and intended use of the requested data within the collecting state agency, political subdi�ision, or statzKide system; (b) whether he may refuse or is legally required to suppiy the requested data; (c) any known consequence arising from his supplying or refusing to supply private or confidential data; and (d) the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shali not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or erccerty tax refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authority, an individual shall be in(ormed whether he is the subject of stored data on individuals, and whether it is classified as public, private or confidential. Upon his further request, an individual ��ho is the subject of stored pri��ate or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be informed of the content and meaning o( that data. After an individual has been shown the private data and intormed of its meaning, the data need not be disclo�r� to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The respom;�le authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately, if possible, with any request made pursuant to this subdivision, or within fn•e days of the date of the request, excluding Saturdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply w7th the request within that time, he shall so inform the individual, and may have an additional five days within which to comply with the request, excluding Saturdays, Sundays and legal holidays. Subd. 4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himsel(. To exercise this right, an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either: (a) correct the data found to be inaccurate or incomplete and attempt to notif�� past recipients of inaccurate or incomplete data, including recipients named by the individual; or (b) notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that }�our request for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The information may be shared with other local, state or federal agencies to the extent necessan• to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may lxcome public. 5. You have certain rights under M.S. 13.04 (available upon request)to revie�v private data on yourself. 6. Your full name is required to process this application or permit. �.�. C��ic� ��<<��C �Vi.�.�� Fust Mid Last '�'z L(� C��c�'' '`�� Address ., _��..c ti..��. /�'lN' SS�l�-, Gj�� _r� �� -!S� City State Zip Phone I unders my rights as st t ove. T � ��° Signature ' CHECK OFF LIST FOR ISSUANCE OF PERMITS � FOR OFFICE USE ONLY ADDRESS OR LEGAL: � Z o � Q2�c.C—..-7� �Pa,�,� �Z-�, PID: DESCRIPTION OF WORK: �4TN ?�an-� I?�.w�,o�p�2 Lz - -----------------------------------------------------------------------------------:--------------- ZONING REVIEW BY: �S �� DATE APPROVED• BUILDING REVIEW BY: DATE APPROVED: z- 9 -o� FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes </ No PLAN REVIEW Yes �/ No SEWER CONNECTION STATE SURCHARGE Yes �/ No WATER CONNECTION INVESTIGATION FEE Yes No v PARK FEE SAC Yes No � SITE INSPECTION Number of SAC Units OTHER (specify) ZONING CHECK LIST Zoning District: /V� CN�}�1l6� Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front (Lake): Right Si : Rear (Street): Left Side: Adjacent Structures: Wetland: Building Height: Def. Hgt. Peak Hgt Lot Coverage: Grading: Staff Approval Date: Council Approval Date: Septic: Staff Approval Date: y: Zoning File: # Resolution: # Resolution Date: Shoreland District: Avg. Setback: Bluff etback: L o t C o v e r a g e : Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS (in house): BUILDING REVIEW CHECK LIST UBC: R�3 CONSTRUCTION TYPE: �!/�( Sq Footage $Per Sq Ftg Basement x = 1 st Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ Z t�,O�c� �o Inspections Required: Work Requiring Separate Permits: Site �Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection X Framing Fireplace Lawn Irrigation �C Insulation (Masonry) Other �_Wall Board (Mfg.) Well (State Permit) � Final Grading/Filling _ps Electrical (State Permit) Other REMARKS (IN HOUSE): ------------------------------------------------------------------------------------------------------------------------ REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: ------------------------------------------------------------------------------------------------------------------------ REMARKS (TO BE NOTED ON PERMIT): 4 �� DATE TIME CITY OF ORONO CALLED IN �7 I-0`� INSPECTION NOT CE /SCHEDULED �-Z-0y �3 d � PERMIT NO. �0��-�✓t,� COMP�ETED ADDRESS ��G ��-��S' �� OWNER CONTR. ��.i.��/'��-S/�-� I�s�� TELEPHONE NO. �D`�I ,�.�C� '�yC.�� DESCRIPTION ��LGr1�. 1� - 117-23 -3?- �f��F l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS � Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 0 12 WATER HOOK-UP 17 SITE INSPECTION 05 FINA 14 SEWER HOOK-UP 06 PROGRESS � EMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J MBI ,� 36 FOUNDATION/REMOVAL � N ONTRACTO TO MEET YOU:IL YES_NO � M NTS: ' � W a - o � ,n�, � � � 0 � W Q P6��5� s�� z W � W � � � ��WORK SATISFACTORY:PROCEED Cl PROJECT COMPLETE W ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT �CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR `�CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContr�ci� site: Inspector. White Copyllnspector's File Canary CopylSite Notice � � � �� DAT � �� TIME CITY OF ORONO CALLED IN � �� INSPECTION N ICE SCHEDULED � PERMIT NO. COMPLETED ADDRESS LlL-Q-f f � 7`- OWNER CONTR. i TELEPHONE N0. � ' I " '" S y� � DESCRIPTION d- � � � � Ot FOOTING 11 MECHANICAL R 18 XCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SE TIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU. YES_NO � COMMENTS: � W a J O � � O � W � Q � 2 W � W � � d W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY � O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (95Z� 249-46QQ OwnerlContracteren ite: Inspector. White Copyllnspector's F le Canary CopylSite Notice